COVARIATE-ADJUSTED ASSOCIATIONS OF COGNITION, DEPRESSIVE SYMPTOMS, AND SOCIAL SUPPORT WITH LIFE SPACE MOBILITY

Abstract Diabetes mellitus is one of the most common chronic diseases among older adults and can affect their movement, participation, and all aspects of daily living, thus restricting life space mobility. Life space mobility reflects individuals’ ability to move independently and engage in social activities. This study examines covariate-adjusted associations of cognition, depressive symptoms, amount of support received and satisfaction with support with life space mobility. The study included 247 older adults aged 65 and above from the University of Alabama at Birmingham (UAB) Diabetes and Aging Study of Health (DASH). Average age was 73, 45% of the sample were Black/African American, 53% were female, and 47% were married. Results from multiple covariate-adjusted regression analyses revealed that being Black/African American, older, female, and higher depressive symptoms significantly predicted lower life space mobility (all p’s < .05) while being married, educated, and reporting better health significantly predicted greater life space mobility. Similarly, higher cognitive function was a significant predictor of greater life space mobility (B = .140, p < .05). Results remained significant even when adjusted for covariates. Amount of support received and satisfaction with support did not predict life space mobility. Findings from this investigation identify individuals who are at risk for restricted life space mobility and suggest protective factors. Establishing these associations with life space mobility within a health disparities framework would be important as it would draw attention to functioning in later life for socially disadvantaged groups and help inform interventions.

of Illinois,Urbana,Illinois,United States,4. University of Kansas Medical Center,Kansas City,Kansas,United States People with dementia (PWD) are at high risk for abuse and neglect.Little is known about the synthesized prevalence rate of abuse among this population though.This study reviewed articles on abuse and neglect among PWD to learn about the pooled prevalence estimates of elder abuse among this population with a meta-analytic approach and examined the heterogeneity associated with the prevalence estimates through meta-regression and subgroup analyses.A total of 27 studies were selected from 479 relevant studies after careful identification using eight academic databases (e.g., ProQuest, CINAHL Plus).All 27 studies received acceptable scores on study quality and demonstrated no significant publication biases.All the studies included a total sample of 11,246 care recipient and caregiver dyads.In addition to overall abuse, three subtypes of elder abuse including physical abuse, emotional abuse, and neglect were examined.Results showed that the pooled prevalence of overall elder abuse was 41% (95%CI [0.31,0.49],p < 0.001).The pooled prevalence of abuse subtypes were 43%(95% CI [0.35, 0.52], p < .001)for emotional abuse, followed by neglect at 16%, and physical abuse at10% (95% CI [0.07, 0.13], p < 0.01).Overall, studies with caregiver average age below 60. reported higher abuse rates than those with caregivers' age over 60.These results call for more policy and practice efforts to assist PWD who are victims of abuse and neglect, and more so, to prevent caregivers from exerting abuse and neglect behaviors toward PWD via education, skills training and support.Elder abuse (EA) has been recognized as a serious public health concern.Recent studies have found that approximately 10% of community-dwelling, cognitively intact older adults experience some form of EA each year.Although EA research has made substantial progress, EA is often under-reported, with only an estimated 15% of cases being reported to formal support services.One of the main reasons for the under-reporting of EA is the victims' feelings of shame, which have been shown to be exacerbated when the perpetrator is a family member and/or an individual with whom the older adults have close trusting relationships.Qualitative interviews conducted with 12 older adult (parent) and adult child caregiver dyads (n=24) revealed that older adults who experience EA by their adult children experience intense shame.Thematic analysis focused on what led to these feelings of shame, and this resulted in four main themes: (1) Failure in their role as a parent; (2) Adult children viewing them as powerless and unworthy; (3) Experiencing negative psychological effects; and (4) Self-blame.With a sense of responsibility to protect their family, older adults tend to keep 'family shame' to themselves, leading to a reluctance to disclose EA.As spouses and adult children, the two most common caregiving types, have also been reported to be the two most common groups of EA perpetrators, gaining a better understanding of the root causes of shame can help to support older adults in living safely in their homes and communities for as long as possible.

CHILDHOOD FAMILY ENVIRONMENT, GENETIC RISK FOR ALZHEIMER'S DISEASE, AND LATE-LIFE COGNITIVE DECLINE
Shiyang Zhang 1 , and Sae Hwang Han 2 , 1.The University of Texas at Austin, Austin, Texas, United States, 2. University of Texas at Austin, Austin, Texas, United States How genetic risks for Alzheimer's disease (AD) interact with environmental factors to shape individuals' cognitive trajectories across the lifespan is a burgeoning area of research.However, relatively little is known about the role childhood family environment plays in the relationship between genetic risk factors for AD and cognitive decline in later life.This study examined whether and how early-life family environments may modify cognitive decline associated with genetic AD risks.Using longitudinal data from the Health and Retirement Study (HRS;1998-2018), we followed over 9,000 individuals aged 51 and older during the observation period spanning nearly two decades.Cognitive functioning was assessed with the full cognitive battery from the HRS.Childhood family environment was evaluated separately with the relationship quality with one's mother and the number of household adults before the age of 16.We estimated a series of multilevel models to assess the association between polygenic risk score for AD (PGS-AD) and changes in cognitive functioning, and whether the association was moderated by the two measures of childhood social capital.Findings indicated that childhood maternal relationship quality, but not the number of household adults, protected against cognitive decline accelerated by PGS-AD.That is, the associations between higher PGS-AD and accelerated cognitive decline were attenuated for individuals who reported a better childhood maternal relationship.Findings are in line with the biopsychosocial model of health and suggest that a better quality of maternal relationships in childhood may have a protective effect on cognitive functioning across the lifespan.

COVARIATE-ADJUSTED ASSOCIATIONS OF COGNITION, DEPRESSIVE SYMPTOMS, AND SOCIAL SUPPORT WITH LIFE SPACE MOBILITY Henrietta Armah, and Olivio Clay, University of Alabama at Birmingham, Birmingham, Alabama, United States
Diabetes mellitus is one of the most common chronic diseases among older adults and can affect their movement, participation, and all aspects of daily living, thus restricting life space mobility.Life space mobility reflects individuals' ability to move independently and engage in social activities.This study examines covariate-adjusted associations of cognition, depressive symptoms, amount of support received and satisfaction with support with life space mobility.The study included 247 older adults aged 65 and above from the University of Alabama at Birmingham (UAB) Diabetes and Aging Study of Health (DASH).Average age was 73, 45% of the sample were Black/African American, 53% were female, and 47% were married.Results from multiple covariate-adjusted regression analyses revealed that being Black/African American, older, female, and higher depressive symptoms significantly predicted lower life space mobility (all p's < .05)while being married, educated, and reporting better health significantly predicted greater life space mobility.Similarly, higher cognitive function was a significant predictor of greater life space mobility (B = .140,p < .05).Results remained significant even when adjusted for covariates.Amount of support received and satisfaction with support did not predict life space mobility.Findings from this investigation identify individuals who are at risk for restricted life space mobility and suggest protective factors.Establishing these associations with life space mobility within a health disparities framework would be important as it would draw attention to functioning in later life for socially disadvantaged groups and help inform interventions.
Abstract citation ID: igad104.2133Music offers a promising non-pharmacological alternative for managing behavioral dysregulations in people with Alzheimer's disease and other dementias (ADRD).Using data from an embedded, pragmatic trial (ePCT) of a personalized music intervention for nursing home (NH) residents with ADRD, we examined resident and NH characteristics associated with exposure to the intervention and dose of music received.Participants were enrolled from 54 NHs (27 treatment,27 control) between June 2019 and February 2020.The intervention was resident-preferred music delivered at early signs of agitation.Intervention dose was calculated by multiplying song duration and number of plays, averaged over days exposed.Facility and resident-level characteristics were identified using the Minimum Data Set and the Certification and Survey Provider Enhanced Reports.A mixed-effects hurdle model was used.483 residents participated (67.7% female, mean age 79.8±12.2years).Female residents (p=0.04)taking antipsychotic medications (p=0.06) were more likely to receive the intervention, as were residents from NHs with greater nursing involvement (p=0.02).Residents with greater health instability received a greater dose (p=0.04).In this ePCT of a personalized music intervention, NHs with more nursing engagement had greater use of the intervention and appropriately chose residents with antipsychotic use to participate.After adjusting for initial selection, staff used the intervention more frequently with residents who had a higher likelihood of death in the next six months, potentially indicating the beneficial use for comfort at the end of life.Our findings offer insights into future tailoring of personalized music interventions to increase the likelihood of successful implementation.

FACTORS ASSOCIATED WITH THE USE OF A PERSONALIZED MUSIC INTERVENTION FOR NURSING HOME RESIDENTS WITH DEMENTIA
Abstract citation ID: igad104.2134

OLDER AGE IS ASSOCIATED WITH TEMPORAL DISCOUNTING OF TIME USE BUT NOT MONETARY REWARDS
Yochai Shavit 1 , Brett Anderson 2 , and Laura Carstensen 3 , 1. Stanford University,Stanford,California,United States,2. MemorialCare Long Beach Medical Center,Anaheim,California,United States,3. Stanford,Stanford,California,United States Age differences in temporal discounting have long puzzled researchers.Although older adults tend to prioritize the present over the future due to more limited time horizons compared to younger adults there is no evidence for an age association with temporal discounting of monetary rewards.Socioemotional selectivity theory posits that as time horizons become more limited goals related to emotional meaning are prioritized over future-oriented goals because they are realized in the present, leading older adults to place more value on experiences than younger adults.A small body of evidence showing age-related preferences for small, immediate, rewards in emotionally meaningful domains is consistent with SST.However, prior studies used hypothetical tasks with vague trade-offs, limiting their interpretability and generalizability.In the present study, we developed a novel paradigm to examine age differences in temporal discounting of rewards related to emotional experience in a controlled environment.120 participants, aged 22-96 years, came to the lab and made a series of choices indicating if they would prefer to replace 5 minutes of boring tasks with an emotionally meaningful variant of the task today, or a larger amount of time in their next visit in six months.Participants then made similar choices about the timing of receiving comparable monetary rewards.We hypothesized that in contrast to monetary rewards, older adults are less likely than younger adults to wait for rewards related to emotional experiences because time becomes increasingly valued as it grows scarce.Findings support the hypothesis and highlight the role of perceived time-horizons.Embedded pragmatic trials encourage the translation of evidence-based interventions to "real-world" settings.Most pragmatic trials of behavioral interventions for people with dementia suffer from low adherence.Understanding how organizational values and structure may increase adherence is important.We report findings from an embedded, pragmatic trial (ePCT) of a personalized music intervention for managing behaviors in residents with dementia, conducted in 54 nursing homes (NHs) from four corporations between June 2019 and February 2020.Before the trial began, the administrator and a nursing staff member from each NH completed the Organizational Culture Assessment Instrument (OCAI).Using the OCAI, respondents rated their

THROUGH THE LOOKING-GLASS: THE FAMILY SHAME OF ELDER ABUSE
Ryan Conard 1 , Ellen McCreedy 2 , Laura Dionne 2 , and Vincent Mor 2 , 1. Brown University, Providence, Rhode Island, United States, 2. Brown University School of Public Health, Providence, Rhode Island, United States

RELATING THE ORGANIZATIONAL CULTURE ASSESSMENT INSTRUMENT TO ADHERENCE IN A PRAGMATIC TRIAL OF A MUSIC INTERVENTION
Enya Zhu, Ellen McCreedy, Laura Dionne, and Vincent Mor, Brown University School of Public Health, Providence, Rhode Island, United States